Monday, January 26, 2009

Trauma: Contagion & Pollution

Republic Day RespiteToday was Republic Day. It is also the 2 month "anniversary" of 26/11 and the 8th anniversary of the Gujarat earthquake.

There was celebration and were parades all day long. The news featured the show of military might of India in parades, and bypass surgery for the PM of India, with many get-well soon sentiments. Yesterday’s meeting with Bombay Psychiatric Society continues to resonate with me as I work on understanding something about trauma in a different light as a consequence of my experiences thus far.

Pollution and TraumaPollution is a strong Hindu idea, very much in the fabric of Indian culture. Siddharth and I were talking with friends about hand washing before and after meals, and he noted that there is often a hand-wash out in the restaurant, a special sink for that purpose, noting that the bathroom, even if very clean, would be considered polluted.

This got me thinking about the idea of traumatic experience being polluting of the purity of the mind. I thought about the Buddhist idea of right thinking, and Yogic ideas of using the mind with clear intention to direct the body, and how in some sense the idea of Yogic control of consciousness over body with the purpose of enlightenment could also be understood as Yogic control of consciousness over unconsciousness. There is a strong pull here away from psychodynamic models, and toward directive models with clear guidelines, such as CBT - if there is any therapy at all.

I wondered if the idea of pollution could fit in with the above, when considering how trauma is often described as “contagious”, especially in vicarious trauma models. On one hand, this could suggest that the other person’s trauma is a disease, and to blame for vicarious trauma, and suggests the idea of contamination or pollution.

Which helps me to conceptualize the distancing responses to trauma I’ve noted in Mumbai so far, which don't quite feel like dissociation or repression, and perhaps the general trend away from reflective capacity – if there is an element of pollution, and therefore contamination, the best bet would be to stay “clean” in the first place. If one could not avoid becoming polluted, then there would be various ways of regaining a state of non-pollution. Since trauma is ubiquitous, there is a problem to be constantly solved.

Mr. CleanAn ongoing effort to maintain psychic cleanliness, bolstered by constant rituals of purification and appeals for luck and removal of obstructions could do the trick. As I’m currently thinking about it, this resembles but does not map completely onto repression or dissociation models of dealing with uncomfortable material, but has added cultural elements typical to South Asia. At the same time, recognizing this re-contextualizes Western ideas such as repression and dissociation into their own cultural framework… Judeo-Christian, Capitalistic/Puritanical… where these concepts become culturally-bound just as much as any other. But bound in the dominant culture…

Sai Baba of ShirdiNot the current living Sai Baba with the voluminous hair, but a figure from Maharashtra representing a unifying agent among multiplicitous religious belief systems. Out for a stroll, we were ushered through a large gate into a temple courtyard. People were extremely eager to draw me into the temple, and according to Siddharth I was taken as kind of a blessing or good omen, being able as pale as an earthworm. I felt shy at first, and the more they gestured for me to enter the more I felt like going at first, feeling trapped or too desired.

I warmed up behind my camera, and eventually ended up sitting among a group of boys and men singing adorational songs. I was concerned about being transgressive taking photos, but as has been the case here with almost no exceptions, everyone is eager to be in photographs. I considered remaining here and starting a religious following, but reluctantly returned to the guest house. The children playing can be quite delightful.

Next Few DaysTomorrow I plan to do some pilot focus groups with university students, with a co-leader Dr. Kamal Jeshwani from HHI, a psychiatry resident currently. He grew up and did part of his training in Mumbai, so we are expecting that element will be a useful part of the group process. Later in the day Siddharth and I are going to give a short presentation for “the public” at Breach Candy Hospital. The next day, a presentation for journalists, and dinner with a psychiatric luminary from Mumbai… if it works out with the traffic and all. Then Siddharth has his 2 day workshop with TISS (Tata Institute for Social Studies), and I will help out with that, but leave before the 2nd day. Then, back in New York for reverse culture shock and jet lag… I expect things will seem different for at least a little while.I hope to be able to get involved in ongoing work in Mumbai.

India’s 9/11?Although I see that 26/11 and 9/11 are quite different, and there is a need to differentiate oneself from the other regardless, there are many parallels which are relevant, in addition to the substantial differences from 9/11. Much of the response on a collective and emotional level is in parallel. There is a sense of having been both caught off guard and humiliated, exposed as vulnerable, an anger at authority for failure to protect, an element of the symbols of economy and wealth, and transportation hubs, being targeted, a desire for military action and a rapid re-establishment of the sense of powerfulness and rightness, and the adoption of much of the same language and security responses, and so on. Perhaps this could be seen as paralleling the difference between “trauma contagion” and “trauma pollution”.